IgA nephropathy is very common disease, perhaps affecting several hundred million people around the globe. Although in many patients it is a rather benign disorder, it can progress to end-stage renal disease (ESRD). The clinical features of IgA nephropathy are quite variable but episodes of hematuria, often combined with persistent proteinuria, are common. Nephrotic syndrome at presentation is uncommon.
Because of the uncertain outlook, it is recommended that all people found to have IgA Nephropathy, even in its mild form, should be seen by their general practitioner and kidney specialist at regular intervals. Indeed healthy individuals with the disease should have blood pressure checks and urine examinations made by their doctor from time to time to pick up the first signs of any problems.
In those who have IgA Nephropathy regular tests of kidney function are necessary because progressive kidney failure can be detected by these tests. Even if someone with IgA Nephropathy appears to be stable, a regular review by a kidney specialist is important.
Primary IgA nephropathy (IgAN) was first described by Jean Berger. One of the difficulties in this disease3–6 is to predict at the time of the initial diagnosis the very long-term (decade) prognosis in the individual patient. This has been approached since the 1990s by the multivariate Cox regression model, taking into account the time duration of follow-up (FU) or the time elapsed since disease onset to occurrence of the events chosen as secondary or primary end points, usually chronic kidney disease (CKD, stage 3+) and end-stage renal failure (ESRF) as strong markers of progression. The predictive risk factors (RF) identified can be classified in two groups: major and the others.
So far there is no curative treatment for IgA Nephropathy. At present the most promising treatments include blood pressure lowering agents (Angiotensin Converting Enzyme (ACE) Inhibitors, Angiotensin Receptor Antagonists (ARA's) and Calcium Channel Blockers). Appropriate treatment including antibiotics for infections and diet will help in many cases, as will restriction of alcohol and tobacco intake and control of cholesterol. There is some evidence supporting the use of fish oil supplements. Rarely, other drugs, such as steroids, cyclophosphamide and mycophenolate are used for nephrotic of more rapidly progressive IgA nephropathy.
kidneyhospitalabroad@hotmail.com
Because of the uncertain outlook, it is recommended that all people found to have IgA Nephropathy, even in its mild form, should be seen by their general practitioner and kidney specialist at regular intervals. Indeed healthy individuals with the disease should have blood pressure checks and urine examinations made by their doctor from time to time to pick up the first signs of any problems.
In those who have IgA Nephropathy regular tests of kidney function are necessary because progressive kidney failure can be detected by these tests. Even if someone with IgA Nephropathy appears to be stable, a regular review by a kidney specialist is important.
Primary IgA nephropathy (IgAN) was first described by Jean Berger. One of the difficulties in this disease3–6 is to predict at the time of the initial diagnosis the very long-term (decade) prognosis in the individual patient. This has been approached since the 1990s by the multivariate Cox regression model, taking into account the time duration of follow-up (FU) or the time elapsed since disease onset to occurrence of the events chosen as secondary or primary end points, usually chronic kidney disease (CKD, stage 3+) and end-stage renal failure (ESRF) as strong markers of progression. The predictive risk factors (RF) identified can be classified in two groups: major and the others.
So far there is no curative treatment for IgA Nephropathy. At present the most promising treatments include blood pressure lowering agents (Angiotensin Converting Enzyme (ACE) Inhibitors, Angiotensin Receptor Antagonists (ARA's) and Calcium Channel Blockers). Appropriate treatment including antibiotics for infections and diet will help in many cases, as will restriction of alcohol and tobacco intake and control of cholesterol. There is some evidence supporting the use of fish oil supplements. Rarely, other drugs, such as steroids, cyclophosphamide and mycophenolate are used for nephrotic of more rapidly progressive IgA nephropathy.
kidneyhospitalabroad@hotmail.com
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